Cervical spondylosis: neck pain from age-related changes, and how it's treated

What is cervical spondylosis?

"Cervical" means the neck, and "spondylosis" means age-related wear in the spine. Cervical spondylosis can include:

• disc changes: the discs between the neck bones losing water and height, sometimes bulging
• facet joint changes: wear in the small joints at the back of the neck
• bone spurs (osteophytes): small bony growths at the edges of the vertebrae

Sometimes these changes press on a nerve root, causing arm symptoms (cervical radiculopathy), or narrow the spinal canal (cervical spinal stenosis).

The same kind of change in the lower back is called lumbar spondylosis.

Symptoms

Many people have no symptoms. When cervical spondylosis does cause problems, you may notice:

• neck pain and stiffness, often worse after holding one position
• reduced movement, such as difficulty turning to look over your shoulder
• pain spreading to the shoulders or between the shoulder blades
• headaches starting at the back of the head
• pain, pins and needles or numbness in an arm or hand, if a nerve is irritated

When neck pain needs urgent help

How it's diagnosed

At your Maana Spine assessment, your physiotherapist asks about your symptoms, checks how your neck and upper back move, tests the strength, sensation and reflexes in your arms (and legs, if needed), and reviews any MRI, X-ray or lab reports you bring. Because spondylosis is so common on scans, the aim is to work out what's actually causing your symptoms.

You'll get a physiotherapy diagnosis and a personalised plan. You don't need a scan to book; if one would help, your physiotherapist will recommend an MRI or X-ray.

→ What happens at your spine assessment

What the research says

Exercise and hands-on care. The 2017 neck pain guideline from the American Physical Therapy Association recommends exercise and hands-on (manual) therapy for many types of neck pain. For pain spreading into the arm, it suggests intermittent neck traction may help when combined with manual therapy and strengthening exercises.

Decompression for the neck. A 2019 double-blind trial of 40 people with a disc problem at the C5-C6 level found pain improved in both groups, while function and disc measurements improved more with traction designed to keep the neck's natural curve. Neck research is thinner than for the lower back, so decompression is always one part of a wider plan.

PST (pulsed signal therapy). PST is a type of pulsed electromagnetic field (PEMF) therapy and is CE-marked. Reviews of PEMF have mostly studied the lower back, where it reduced long-lasting pain. We haven't found good-quality PEMF trials specifically in cervical spondylosis.

Will I need surgery?

Most people with cervical spondylosis don't need surgery. Surgery is considered when there are signs of pressure on the spinal cord, or worsening weakness. Non-surgical care is a reasonable first step for most people. If your assessment suggests you should see a doctor or surgeon, we'll tell you honestly.

→ Cervical spinal stenosis and myelopathy

Practical tips

• Keep your neck moving with gentle movements through the day.
• Change position often at work, on your phone and on long rides.
• Use a supportive pillow that keeps your neck comfortable.
• Keep up your home programme. Regular exercise makes the biggest long-term difference.

These are general tips, not a substitute for an assessment.

When to book a spine assessment

Book an assessment if neck pain or stiffness has lasted more than a couple of weeks, keeps coming back, spreads into your arm, or causes headaches. Spine assessments are available at all five Maana Spine clinics in Kochi, Kozhikode, Thiruvananthapuram, Aluva and Perinthalmanna. The consultation fee is ₹250, and no doctor's referral is needed.

Book a Spine Assessment · or call or WhatsApp +91 99950 09403